Acupuncture for breathlessness

Does it work?

Systematic reviews

Systematic reviews of various interventions for breathlessness in advanced stages of malignant and non-malignant diseases located five RCTs including a single RCT in cancer (described below). The conclusions were that there was not enough evidence to recommend the routine use of acupuncture/acupressure.10,11 One of these reviews has been withdrawn for updating and is not currently available.11

Randomised controlled trials

One RCT involved the treatment of 47 patients suffering from advanced breast or lung cancer and breathlessness.12 They received a single session of real or sham acupuncture in addition to standard drug treatments. Semi-permanent studs were subsequently inserted for twice daily self-treatments. Follow-up was one week. The results show a slight but statistically not significant advantage in terms of symptomatic relief for the real acupuncture group. The authors concluded that the acupuncture technique used in this trial is unlikely to have effects on dyspnoea (breathlessness) 'importantly larger than placebo' for patients with advanced cancer.

Uncontrolled clinical trials

An open and uncontrolled pilot-study included 20 cancer patients with severe breathlessness at rest. They were treated with one acupuncture session, and subsequently 14 patients reported marked symptomatic relief.13 The authors concluded that the therapeutic value of acupuncture in the management of breathlessness requires further evaluation.

Whether breathlessness due to conditions other than cancer can be effectively treated with acupuncture is also not clear. Trials have generated both positive 14 as well as negative answers.15 A more recent systematic review on the effects of acupuncture in chronic obstructive pulmonary disease concluded that, overall, there were indications of beneficial effects on dyspnoea.16 Further research is needed to provide conclusive evidence because of the small numbers and moderate quality of the trials, variation in the interventions tested and short treatment duration.

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